New York physicians have identified two female chronic cocaine users who had severe necrosis (death) of tissues in their cheeks and earlobes that the doctors believe is linked to the women’s use of cocaine. But it is not the drug itself that is causing the damage; it is  another drug that is used to cut the cocaine: levamisole.

Levamisole is used to treat worms in dogs and other animals. Although it was once used in this country in humans as well, its use has been discontinued for several years, although the drug is still available for human use in South America. It was banned because it causes neutropenia, a deficiency of key white blood cells that are important for fighting off infections, and vasculitis, an inflammation of blood vessels that can cut off the flow of blood to tissues.

According to some estimates, as much as 70% of cocaine coming into the United States in recent months was cut with levamisole. (Cutting is the process of diluting the drug with a similar powder to reduce its potency and to enable drug sellers to make more money on a given weight of cocaine.) No one seems to know why levamisole is being used because it is more expensive than other cutting agents and is not known to increase the potency of the drug or to produce desirable side effects. Moreover, it is unusual for cocaine producers to cut the drug before shipping because that increases their shipping costs.  (Read More).